Minimally Invasive Fixation for Distal Radius Fractures

ABSTRACT

Fixed angle fixation permits early function after distal radius fractures. A treatment method that provides the benefits of this fixation type through a minimally invasive approach is presented.

All patients treated between January 2002 and June 2003 at our center for unstable distal radius fractures using a new fixation implant were retrospectively reviewed. The DNP is a fixed angle nail-plate hybrid device designed to be applied through a small dorsal incision and with minimal soft-tissue disruption. Postoperative management included immediate finger motion, early functional use of the hand, and a wrist splint used for an average of 3 weeks. Standard radiographic fracture parameters were measured and final functional results were assessed by measuring digital motion, wrist motion, and grip strength.

Of 23 patients who fit the inclusion criteria, 20 patients with 21 unstable distal radius fractures had average 31-week follow-up. Three patients were lost to follow-up. All patients were treated as outpatients under regional anesthesia. Final volar tilt averaged 8º, radial tilt 22º, and radial shortening,1 mm. The average final dorsiflexion was 60º, volar flexion 45º, pronation 83º, and supination 80º. Grip strength was 72% of the contralateral side. No device failures or significant reduction loss were noted.

It is possible to treat unstable distal radius fractures with a fixed angle device applied through a minimally invasive approach, providing stable internal fixation and allowing early function in the elderly or infirm patient who is a poor candidate for a more extensive surgical procedure. This technique allows early return to function, provides good final results, and presents a low complication rate.